Experiences of midwives on active management of third stage of labour in district hospitals, Omusati region
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Date
2019
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Publisher
University of Namibia
Abstract
Active Management of Third Stage of Labour can prevent post-partum haemorrhage. According to Prevention of Postpartum Hemorrhage Initiative (POPPHI, 2009), active management of the third stage of labor (AMTSL) can reduce the incidence of postpartum hemorrhage by up to 60%. According to Marshall, Buffington, Beck and Clark (2008), postpartum hemorrhage is one of the leading causes of maternal deaths in many countries, accounting for 60% of maternal deaths. This fact is also true for Namibia where the highest direct cause of maternal deaths for the period April 2010 to March 2012 was linked to bleeding after delivery (MoHSS, 2014). The purpose of the study was to explore and describe midwives’ experiences on AMTSL in Omusati region. The study objectives were to explore midwives’ experiences on AMTSL and describe the midwives’ experiences on AMTSL. The study employed a qualitative, explorative, descriptive and contextual design that used focus group discussion and individual interviews to collect data that was analyzed through content analysis. Purposive sampling method was used to select nineteen participants from among 53 midwives distributed across the four district hospitals in Omusati region involved in the study. The study revealed that there was good awareness and knowledge of AMTSL among midwives in Omusati region, and the study participants expressed positive experience in using AMTSL to manage the third stage of labour as they have noted decreased incidence of post-partum haemorrhage and shortened delivery time in applying the method. However, some midwives in Omusati region lacked proper understanding of AMTSL. Midwives in Omusati region experienced challenges in implementing AMTSL due to insufficiency in staff coverage in labour wards and oxytocin stored in rooms outside the delivery room. This has often resulted in oxytocin not being administered within the recommended time frame during AMTSL. Recommendations are made in this study to improve maternal care services by availing updated guidelines, offer refresher courses and supportive supervision. The researcher also recommends improvement in staff coverage in labour wards, keeping a fridge in labour room where oxytocin is stored will prevent some delays in giving oxytocin. Areas for future research including the impact of staff shortage on quality obstetric care in the country have been highlighted.
Description
A research thesis submitted in fulfillment of the requirements for the Degree of Master of Public Health
Keywords
Midwives